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Aesthetic corneal tattooing/keratopigmentation using tattoo pen machine: choosing suitable method and color

  • Cornea
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Abstract

Purpose

This article aims to present the corneal tattooing method and how using a tattoo pen machine can improve aesthetic appearance in patients with corneal leukoma.

Methods

In this study, 42 patients were evaluated who had no visual potential and who had undergone colored corneal tattooing using an automatic tattoo pen machine for aesthetic purposes. The procedure was conducted according to the principles of the Declaration of Helsinki. The commercially available tattoo ink that has traditionally been used on human skin (brown, green, and black) for years was used for all the patients in this study, and 252 corneal photographs (with a Topcon slit lamp imaging device at 16 magnifications, i.e., 16 ×) taken within the last 2 years were evaluated retrospectively. Red, green, and blue (RGB) and hue, saturation, and lightness (HSL) values of the tattooed areas, such as pupils and iris, in corneal photographs were determined online using the Color Code Finder program. The RGB and HSL values of the pupil and iris were compared before surgery on the first day and first week, first month, third month, and twelfth month after surgery.

Results

In the first postoperative month, the mean pupil lightness (L) and iris L values were found to have increased by 10.7% and 5.7%, respectively. Between the first month and the first year, the L value of the mean pupil and that of the iris increased by 1.7% and 5.2%, respectively. The increase in the RGB value of the mean pupil in the first month was statistically significant (p = 0.02). The highest increase in RGB values of the iris was observed in the first week and first month (p = 0.113). This result shows that the majority of fading occurred in the first month. After the first month, the increase in the L value in the black-colored pupil was less than that in the brown- or green-colored iris. These results show that light colors fade faster and more.

Conclusion

Esthetically, corneal leukoma causes severe psychological problems. Many patients are unable to use prosthetic contact lenses. Evisceration surgery has many complications, and limbal stem cells are used in evisceration surgery. Corneal tattooing using a tattoo pen machine is an easy, practical, and repeatable method used for aesthetic purposes. Successful results require the use of appropriate methods, ink, and ophthalmologist’s experience. All patients in this study had a more aesthetic appearance than the preoperative white eye. Further studies are needed to develop a colored aesthetic tattooing method with a tattoo pen machine.

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Authors and Affiliations

  1. Department of Ophthalmology, Goztepe Prof. Dr. Süleyman Yalçin City Hospital, Istanbul, Turkey

    Omer Faruk Yilmaz & Halit Oguz

  2. Department of Ophthalmology, Faculty of Medicine, Istanbul Medeniyet University, Istanbul, Turkey

    Halit Oguz

Authors
  1. Omer Faruk Yilmaz
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  2. Halit Oguz
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Correspondence to Omer Faruk Yilmaz.

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All procedures performed in studies involving human participants were by the ethical standards of the (Ethics Committee of Istanbul Medeniyet University Göztepe Training and Research Hospital clinical research. Decision number: 2022/0154) and with the 1964 Helsinki Declaration and its later amendments or comparable ethical standards.

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Yilmaz, O.F., Oguz, H. Aesthetic corneal tattooing/keratopigmentation using tattoo pen machine: choosing suitable method and color. Graefes Arch Clin Exp Ophthalmol 261, 3531–3540 (2023). https://doi.org/10.1007/s00417-023-06135-9

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  • DOI: https://doi.org/10.1007/s00417-023-06135-9

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